Susan Furth, M.D., Ph.D. is a Professor of Pediatrics and Epidemiology applying to renew a Mid-career Award in Patient Oriented Research (K24). Dr. Furth has an outstanding record of mentorship and accomplishment. During the first 4 years of this award, Dr. Furth successfully mentored medical students, fellows and junior faculty; 6 of whom have received NIH K23, KL2 or K08 career development awards, and 4 foundation or pilot grant awards, all are pursuing research in academia, government or foundations. She continues to work with and lead the NIH/NIDDK's Chronic Kidney Disease in Children Cohort (CKiD) Study, a 586-person cohort study of children with CKD in the US and Canada funded since 2003. For this renewal application, Dr. Furth will continue her mentoring activities for both post-doctoral trainees and junior clinician researchers, the majority also receive formal research training in the Masters of Science Program in Clinical Epidemiology at the University of Pennsylvania.. Dr. Furth anticipates being the primary faculty mentor for 2 to 3 post-doctoral fellow mentees per year, and providing mentorship for junior faculty pursuing ancillary studies in CKiD. Her patient oriented research activities will continue to address problems in CKD, focusing on the period of disease before individuals become dependent on dialysis or transplantation. CKiD has met its initial enrollment goals and is now re-opening enrollment, and planning for a 5 year renewal application in 2013. In this K24 renewal, Dr. Furth will extend the research opportunities for her mentees through CKiD and her role on the PediGFR study, a funded ancillary R01 to CKiD which will include genotyping of a cohort of 1482 children with CKD in the CKiD study, as well as in the European ESCAPE and 4C studies. CKiD, and the ancillary PediGFR study, provide an ideal platform on which to conduct the study of genetic contributions to CKD causes, progression and associated comorbidities. The additional research aims of this K24 application address the genetic contributions to the significant problem of anemia and treatment resistance in CKD. Investigating genetic contributions to anemia susceptibility and treatment resistance may yield innovative therapeutic targets. Cross- sectional and longitudinal analyses will expand our understanding of the genetic contributions to anemia and treatment resistance in CKD. The approach of combining data from existing funded studies including CKiD and PediGFR as a platform for mentorship will increase the productivity of the parent studies and propel the careers of junior investigators to become the next generation of leaders in kidney disease research. PUBLIC HEALTH RELEVANCE: As the prevalence of chronic kidney disease (CKD) in the US remains high and the associated costs to Medicare are staggering, improved strategies for prevention and treatment of CKD complications are crucial to curb the public health burden of this disease. As an experienced and successful mentor, Dr. Furth proposes to renew her K24 funding to continue mentorship of young patient-oriented researchers in the areas of clinical epidemiology, and translational research with the dual objectives of improving the care of children with kidney disease, and nurturing the next generation of patient oriented researchers in pediatric nephrology. The research aims in this application expand on Dr. Furth's research in CKD in children to utilize new tools exploring genetic contributions to anemia in CKD to illuminate new pathophysiologic mechanisms and potential treatment targets that would be applicable to both children and adults with CKD.